EP0939606B1 - Instrument endochirurgical dote d'un effecteur terminal a mouvement radial - Google Patents
Instrument endochirurgical dote d'un effecteur terminal a mouvement radial Download PDFInfo
- Publication number
- EP0939606B1 EP0939606B1 EP96915546A EP96915546A EP0939606B1 EP 0939606 B1 EP0939606 B1 EP 0939606B1 EP 96915546 A EP96915546 A EP 96915546A EP 96915546 A EP96915546 A EP 96915546A EP 0939606 B1 EP0939606 B1 EP 0939606B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- push rod
- tube
- end effector
- distal end
- coupled
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/320036—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes adapted for use within the carpal tunnel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2936—Pins in guiding slots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
- A61B2017/294—Connection of actuating rod to jaw, e.g. releasable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2944—Translation of jaw members
Definitions
- This invention relates broadly to endosurgical instruments. More particularly, this invention relates to an endosurgical instrument having an end effector which is radially movable.
- endoscopic surgery is widely practiced throughout the world today and its acceptance is growing rapidly.
- endoscopic/laparoscopic surgery involves one or more incisions made by trocars where the trocar tubes are left in place so that endoscopic surgical tools may be inserted through the tubes.
- a camera, magnifying lens, or other optical instrument is often inserted through one trocar tube, while a cutter, dissector, or other surgical instrument is inserted through the same or another trocar tube for purposes of manipulating and/or cutting the internal organ.
- Endoscopic surgical instruments generally include a slender tube containing a push rod which is axially movable within the tube by means of a manual actuator.
- One or more end effectors are coupled to the distal ends of the tube and the push rod so that axial movement of the push rod is translated to rotational or pivotal movement of the end effector(s).
- End effectors may take the form of scissors, grippers, cutting jaws, forceps, and the like.
- Endosurgical scissors usually include a pair of scissor elements (blades) attached to each other or a clevis by a pivot axle. These scissors may be single acting or double acting.
- a first scissor element is held stationary relative to the distal end of the tube and a second scissor element is rotated about the pivot axle relative to the first scissor element.
- Endosurgical scissors are available in many forms, e.g. curved blades, hooked blades, angled blades, etc. However, most endosurgical scissors have relatively sharp distal ends and cut in the distal direction.
- Endosurgical grippers and forceps are similar in design to endosurgical scissors, but with a pair of gripping elements rather than a pair of scissor blades.
- the common design features of endosurgical grippers, forceps, and scissors present the disadvantage that they grip or cut in a distal direction. This tends to push the subject tissue away from the instrument which results in a possible failure to cut or grip the tissue.
- U.S. Patents Numbers 4,963,147 and 5,089,000 to Agee et al. partially address the problems encountered with conventional endosurgical cutting instruments. Both of these patents disclose a surgical instrument for the treatment of carpel tunnel syndrome.
- the cutting instrument disclosed by Agee et al. includes a hollow tube having a radial slit and a single cutting blade which is movable into and out of the radial slit by a push rod.
- the distal end of the tube is provided with a slotted rotatable pivot member through which the cutting blade is translated and rotated. In use, the cutting blade exits the radial slot in the tube with its sharp point angled in the distal direction and its cutting edge forming an obtuse angle with the proximal portion of the tube.
- the pivot member allows the blade to rotate slightly in the proximal direction as it exits the tube.
- the instrument is fairly complex and cutting is effected in a direction away from the tube.
- any tissue adjacent to the radial slot in the tube is exposed to the sharp point and cutting edge of the cutting blade.
- U.S. Patent Number 4,729,374 to Alfranca discloses a surgical instrument for transcholedochal papillotomy which includes a flexible coil with a single acting retrograde scissor end effector coupled to its distal end and a pull wire extending through the coil and coupled to the end effector.
- the end effector includes a fixed blade coupled to the distal end of the coil and having a blunt distal end and a movable blade distally hinged to the fixed blade.
- the distal end of the pull wire is coupled to the movable blade by a connecting rod which is hingedly connected to both the pull wire and the movable blade.
- a proximal handle with a displaceable spool moves the pull wire through the coil to open and close the movable blade. While the instrument may be effective in performing a retrograde cutting operation, it is mechanically complex and difficult to manufacture.
- U.S. Patent Number 5,112,346 to Hiltebrandt et al. discloses a retrograde cutting hook punch having a hollow tube with a push rod extending through it and a single acting end effector coupled to the distal ends of the tube and the push rod.
- the end effector includes a stationary member which is coupled to the distal end of the tube and a movable member which is distally hinged to the stationary member and hingedly coupled to the distal end of the push rod.
- the cutting hook punch is designed specifically for arthroscopic procedures and has a complex geometry. Like the cutting instrument disclosed by Alfranca, the cutting hook punch has at least two hinged couplings.
- an endosurgical cutting instrument generally includes a hollow tube having a distal end with a radial slot and an interior inclined deflection surface, a push rod extending through the tube and having a proximally directed sickle blade coupled to its distal end, and a manual actuator coupled to the proximal ends of the tube and the push rod for imparting relative axial movement to the tube and push rod.
- the sickle blade is a curved member having a sharp concave edge and a dull convex edge and is coupled to the distal end of the push rod with its sharp concave edge facing the push rod.
- the sickle blade is dimensioned such that it may be substantially completely contained within the diameter of the hollow tube.
- the push rod is oriented so that its distal end is free to move in a radial direction as it moves axially.
- the inclined deflection surface is preferably arranged at the distal end of the tube such that axial movement of the push rod against the deflection surface urges the push rod in a radial direction (i.e. up the inclined deflection surface) thereby causing the sickle blade to exit the tube through the radial slot.
- cutting When tissue is thus captured, cutting may be effected in a radial direction by proximal axial movement of the push rod which draws the blade back into the tube, and cutting may be effected in a proximal direction by proximal movement of the entire cutting instrument with the blade deployed.
- the cutting instrument according to the invention is therefore atraumatic at-all times prior to the actual cutting operation.
- the instrument is directed to the surgical site with the cutting blade contained within the tube and the cutting blade is deployed without exposing its sharp edge to adjacent tissue.
- the deflection surface is formed as a substantially cylindrical inclined passage and the distal end of the push rod is provided with a piston-like member which rides in and is guided by the passage.
- clamping and/or dissecting instruments utilizing the inclined deflection surface of the invention are also provided.
- the clamping and dissecting instruments include forward acting and retrograde instruments.
- an endosurgical cutting instrument 100 generally includes a hollow tube 102, a push rod 104 extending through the hollow tube, a proximal handle actuator 106 coupled to the proximal ends of the tube and push rod, and a sickle cutting blade 108 coupled to the distal end of the push rod 104.
- the distal end of the tube 102 is provided with a radial slot 110 and an inclined distal deflecting surface 112.
- the proximal handle actuator 106 includes a handle portion 114 which is coupled to the proximal end of the tube 104 and a lever portion 116 which is coupled to the proximal end of the push rod 104.
- the lever portion 116 is rotatably coupled to the handle portion 114 by a pivot axle 118. Rotation of the lever portion 116 relative to the handle portion 114 results in axial movement of the push rod 104 relative to the tube 102.
- the proximal end of the push rod 104 is preferably coupled to the lever 116 by a ball and socket or disk and socket coupling 117 as described more fully in co-owned U.S. Patent Number 5,174,300, the complete disclosure of which is incorporated herein by reference.
- axial movement of the push rod 104 relative to the tube 102 results in a non-rotational radial movement of the cutting blade 108 in or out of the radial slot 110.
- the cutting blade 108 is a curved sickle-like member having a sharp proximal end 120, a dull convex edge 122, a sharp concave edge 124, and a distal end 126 which is coupled to the distal end 128 of the push rod 104.
- the deflecting surface 112 is a cylindrical guide channel which is inclined in the distal direction and intersects the radial slot 110 in a radial hole 111 which is distally adjacent to the slot 110 as seen best in Figure 5.
- the cylindrical guide channel 112 is provided with a proximal lateral opening 113 extending along substantially its entire length and dimensioned to admit the distal end 128 of the push rod 104 and the distal end 126 of the cutting blade 108.
- the distal ends of the cutting blade and the push rod are coupled to each other via a substantially cylindrical piston-like member 130 which slides in the guide channel 112.
- the piston-like member 130 may be formed as part of the blade 108, part of the push rod 104, or may be a separate member which is glued, welded or otherwise affixed to the blade and the push rod.
- the tube 102 has a distal end 115 which exhibits an angled planar surface which is substantially parallel to the axis of the guide channel 112.
- a distal end surface may be useful in deflecting tissue away from the slot 110 when the instrument is moved distally.
- end surfaces such as hemispherical, conical, frustroconical, etc. may provide other desirable effects without interfering with the operation of the instrument.
- the embodiment of Figures 1-5 may be assembled as follows:
- the tube 102 is provided with an open end 115 in addition to the radial slot 110 and a radial hole 111 at the distal end of the slot 110.
- the blade 108, piston-like member 130, and the push rod 104 are assembled and inserted into the distal end 115 of the tube 102.
- the piston-like member 130 is aligned with the radial hole 111, and the cylindrical guide channel 112 is inserted into the radial hole 111.
- the distal end 115 of the tube 102 is sealed with epoxy or the like which also maintains the channel 112 securely at the distal end of the tube.
- FIG. 6 shows an alternate embodiment of a cutting blade 208 which has a sharp proximal end 220, a dull convex edge 222, a concave edge 224a, 224b, and a distal end 226.
- the concave edge has a sharp proximal portion 224a and a dull distal portion 224b.
- the purpose of the dull portion 224b is to allow the instrument to gently move a tissue, vein, duct, or other structure (not shown).
- the object can be pulled to a location away from any adjacent tissue, where positive identification by imaging or other equipment can be achieved.
- the cutting operation with the sharp cutting portion 234a of the blade 308 proceeds by retracting the blade 208 in the slot 110.
- the tube 102 and the push rod 104 are made of stainless steel and the cutting blade 108 is a cobalt base alloy as disclosed in co-owned U.S. Patent #5,234,453.
- the tube 102 preferably has a diameter of approximately 4,47 mm (0.176") and the push rod 104 preferably has a diameter of approximately 1,52 mm (0.060").
- the slot 110 is preferably configured to act as a shearing edge relative to the sharp edge 124 (224a) of the blade 108 (208).
- the guide channel 112 is preferably inclined at an angle of approximately 60°.
- the convex edge 122 (222) of the cutting blade 108 (208) has a radius of curvature of approximately 9,53 mm (0.375") and the concave edge 124 (224) has a radius of curvature of approximately 6,35 mm (0.250").
- the inclined deflection surface according to the invention may be used with an end effector other than a cutting blade.
- the end effector may take the form of a gripper/dissector as shown in Figures 7-18.
- an endosurgical gripping/dissecting instrument 300 is similar to the cutting instruments described above having a hollow tube 302 and a push rod 304 extending therethrough.
- the tube 302 is provided with a distal inclined deflection surface, in this case an inclined cylindrical channel 312, and the distal end of the push rod 304 engages the deflection surface, in this case by means of a cylindrical piston-like member 330.
- the tube 302, in this embodiment of the invention, is provided with a radial hole 311 adjacent to the channel 312, but no radial slot is necessary.
- a gripper/dissector 308 is formed as a hollow cylinder segment and is coupled to the piston-like member 330 by an extension arm 309.
- the gripper/dissector 308 substantially embraces the upper distal surface of the tube 302.
- the push rod 304 is moved distally, the piston-like member 130 engages the inclined guide channel 312 and moves upward toward the hole 311 in the tube 302.
- the extension arm 309 rises out of the hole 311 and the gripper/dissector 308 is moved radially and distally from the tube 302 to the deployed position shown in Figures 9 and 10. Movement of the push rod 304 in the proximal direction will return the gripper/dissector 308 to the retracted position shown in Figures 7 and 8.
- FIGs 11-14 show another endosurgical gripping/dissecting instrument 400 according to the invention.
- the gripping/dissecting instrument 400 is similar to the instrument 300 described above and similar reference numerals refer to similar parts of the instrument.
- the instrument 400 differs from the instrument 300 in that a distal portion 410 of the tube 402 is flattened and the gripper/dissector 408 is a solid cylinder segment rather than a hollow one.
- the gripper/dissector 408 In the retracted position shown in Figures 11 and 12, the gripper/dissector 408 is nested on the flattened portion 410 of the tube 402.
- the gripper/dissector 408 In the deployed position shown in Figures 13 and 14, the gripper/dissector 408 is raised above the flattened portion 410 of the tube 402.
- the operation of the instrument 400 is substantially the same as the operation of the instrument 300.
- each of the instruments has common features, e.g., each has an end effector which is moved radially and distally by the push rod engaging a deflecting surface.
- each of the instruments above may be considered to be "retrograde” or backward acting. It will be appreciated, however, that the deflecting surface feature of the invention can be used with an instrument which is forward acting.
- FIGs 15-18 show an embodiment of a gripper/dissector instrument 500 which is similar to the instrument 400 described above and in which similar reference numerals refer to similar parts of the instrument.
- the guide channel 512 is located proximally of the distal end 515 of the tube 502.
- the space between the gripper/dissector 508 and the flattened part 510 of the tube 502 is open at the distal end of the instrument and not blocked in any way by the extension arm 509, as compared to the extension arm 409 in Figures 11-14 which blocks the distal end access to the space between the gripper/dissector 408 and the flattened part 410 of the tube 402.
- the instrument 400 is retrograde in the sense that the end effector 408 must be brought behind the object to be grasped
- the instrument 500 is forward acting since the end effector 508 can grasp an object by approaching it from the front.
- the end effector rather than coupling the end effector to the push rod at the location of the deflection surface, it is possible to locate the end effector to rod connection proximally of the deflection surface. In this case, the slot or hole in the tube must be provided at the end effector to rod connection location rather than at the deflection surface location.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Claims (10)
- Instrument endochirurgical (100, 300, 400, 500) comprenant ;(a) un tube creux (102) ayant une extrémité proximale, et une extrémité distale, et une paroi définissant une ouverture radiale à proximité de ladite extrémité distale ;(b) une tige poussoir (104) ayant une extrémité proximale et une extrémité distale, ladite tige poussoir s'étendant au moins partiellement à travers ledit tube creux ;(c) un effecteur terminal (108, 208, 308, 408, 508) couplé à ladite tige poussoir avec ledit effecteur terminal s'étendant au moins partiellement à l'extérieur dudit tube et couplé à ladite tige poussoir à travers ladite ouverture radiale lorsque ledit effecteur terminal se trouve dans une position déployée ; et(d) un moyen d'actionnement (106) couplé à ladite extrémité proximale dudit tube creux et à ladite extrémité proximale de ladite tige poussoir pour effectuer un mouvement axial relatif desdits tube et tige poussoir,caractérisé en ce que l'instrument comprend en outre une surface de déflexion (112) à l'intérieur dudit tube creux et à proximité de ladite extrémité distale dudit tube creux ; le mouvement axial relatif desdits tube (102) et tige poussoir (104) conduisant à ce que ladite extrémité distale (128) de ladite tige poussoir et ladite surface de déflexion (112) se mettent en prise de sorte que ledit effecteur terminal est déplacé de manière radiale et distale par rapport audit tube.
- Instrument endochirurgical selon la revendication 1, dans lequel ledit effecteur terminal est une lame de coupe ou une pince/un dissecteur.
- Instrument endochirurgical selon la revendication 1 ou 2, dans lequel ladite ouverture radiale comprend une fente radiale, et ledit effecteur terminal est de préférence une lame de coupe incurvée ayant un bord tranchant et un bord non tranchant, ledit bord tranchant étant tourné de manière proximale et radiale vers l'intérieur par rapport à ladite tige poussoir.
- Instrument endochirurgical selon l'une quelconque des revendications précédentes, dans lequel ledit effecteur terminal est une lame de coupe en forme de faucille et a un bord interne et un bord non tranchant externe, ledit bord interne a en outre une partie non tranchante distale et une partie tranchante proximale.
- Instrument endochirurgical selon la revendication 1 ou 2, dans lequel ledit effecteur terminal est une pince/un dissecteur couplé(e) audit élément sensiblement cylindrique par un bras d'extension qui s'étend à travers ladite ouverture radiale.
- Instrument endochirurgical selon la revendication 1 ou 2, dans lequel ledit effecteur terminal est une pince/un dissecteur qui se présente sous la forme d'un segment d'un segment de cylindre creux qui englobe ledit tube lorsque ledit effecteur terminal est déplacé vers une position rétractée ; et
une partie distale dudit tube est de préférence aplatie et ladite pince/ledit dissecteur se présente de préférence sous la forme d'un segment d'un segment de cylindre solide qui s'emboîte sur ladite partie aplatie dudit tube lorsque ledit effecteur terminal est déplacé vers une position rétractée. - Instrument endochirurgical selon l'une quelconque des revendications précédentes, dans lequel ladite surface de déflexion est sensiblement cylindrique, et est de préférence inclinée dans la direction distale ; et/ou
dans lequel ledit moyen d'actionnement comprend une poignée couplée à ladite extrémité proximale dudit tube et un levier couplé de manière pivotante à ladite poignée et couplé à ladite extrémité proximale de ladite tige poussoir. - Instrument endochirurgical selon l'une quelconque des revendications précédentes, dans lequel ladite surface de déflexion est un canal de guidage sensiblement cylindrique ayant une extrémité ouverte adjacente à ladite ouverture radiale et une ouverture latérale proximale; et
ladite extrémité distale de ladite tige poussoir est de préférence munie d'un élément similaire à un piston sensiblement cylindrique qui coulisse dans ledit canal de guidage. - Instrument endochirurgical selon l'une quelconque des revendications précédentes, dans lequel ladite surface de déflexion est un canal de guidage sensiblement cylindrique ayant une extrémité ouverte adjacente à ladite ouverture radiale et une ouverture latérale proximale ; et ladite extrémité distale de ladite tige poussoir est munie d'un élément similaire à un piston sensiblement cylindrique qui coulisse dans ledit canal de guidage.
- Instrument endochirurgical selon l'une quelconque des revendications précédentes, dans lequel ledit effecteur terminal est couplé de manière sensiblement rigide à ladite extrémité distale de ladite tige poussoir, et lesdits effecteur terminal et tige poussoir sont déplacés dans une ligne droite formant un angle par rapport audit tube.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/436,121 US5586990A (en) | 1995-05-08 | 1995-05-08 | Endosurgical instrument with a radially movable end effector |
US436121 | 1995-05-08 | ||
PCT/US1996/006407 WO1996035381A1 (fr) | 1995-05-08 | 1996-05-07 | Instrument endochirurgical dote d'un effecteur terminal a mouvement radial |
Publications (3)
Publication Number | Publication Date |
---|---|
EP0939606A1 EP0939606A1 (fr) | 1999-09-08 |
EP0939606A4 EP0939606A4 (fr) | 2001-02-14 |
EP0939606B1 true EP0939606B1 (fr) | 2007-01-10 |
Family
ID=23731193
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP96915546A Expired - Lifetime EP0939606B1 (fr) | 1995-05-08 | 1996-05-07 | Instrument endochirurgical dote d'un effecteur terminal a mouvement radial |
Country Status (6)
Country | Link |
---|---|
US (1) | US5586990A (fr) |
EP (1) | EP0939606B1 (fr) |
AU (1) | AU5729696A (fr) |
CA (1) | CA2220493A1 (fr) |
DE (1) | DE69636839T2 (fr) |
WO (1) | WO1996035381A1 (fr) |
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US6679886B2 (en) | 2000-09-01 | 2004-01-20 | Synthes (Usa) | Tools and methods for creating cavities in bone |
US7037276B2 (en) * | 2002-07-02 | 2006-05-02 | Precision Medical Devices, Inc. | Biopsy device |
US9597078B2 (en) * | 2003-04-29 | 2017-03-21 | Covidien Lp | Surgical stapling device with dissecting tip |
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EP1897506B1 (fr) * | 2006-09-08 | 2010-03-03 | Ethicon Endo-Surgery, Inc. | Instrument chirurgical pour réaliser des myotomies controlées |
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US8257312B2 (en) * | 2008-07-30 | 2012-09-04 | Medtronic, Inc. | Integrated slitter for medical instrument inserter |
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JP5926688B2 (ja) | 2010-01-20 | 2016-05-25 | コンベンタス オーソピディックス, インコーポレイテッド | 骨へのアクセスおよび空洞設備のための装置および方法 |
WO2011112615A1 (fr) | 2010-03-08 | 2011-09-15 | Krinke Todd A | Appareil et procédés de fixation d'implant osseux |
US8771306B2 (en) * | 2010-03-11 | 2014-07-08 | Covidien Lp | Insertion device and method of use |
JP6302842B2 (ja) * | 2012-01-06 | 2018-04-11 | シン, ジワン スティーブンSINGH, Jiwan Steven | 挿入具および腹腔鏡器具用挿入システム |
CN105939677A (zh) | 2013-12-12 | 2016-09-14 | 康文图斯整形外科公司 | 组织移位工具和方法 |
CN104799909B (zh) * | 2015-03-19 | 2016-06-29 | 哈尔滨医科大学 | 消化内镜微创手术用双关节镰状刀 |
US10499942B2 (en) | 2016-02-24 | 2019-12-10 | Ira Lown | Carpal tunnel release systems and methods |
US11253285B2 (en) * | 2016-04-04 | 2022-02-22 | University Of Utah Research Foundation | Subcutaneous cutting device |
WO2018129167A1 (fr) * | 2017-01-05 | 2018-07-12 | Gowski William F | Appareil à sonde et lame déployables et procédés d'utilisation |
US10667837B2 (en) * | 2017-01-05 | 2020-06-02 | William F. Gowski | Apparatus with deployable probe and blade and methods of use |
US11596431B2 (en) | 2017-01-05 | 2023-03-07 | William F. Gowski | Apparatus with deployable probe and blade and methods of use |
US10631881B2 (en) | 2017-03-09 | 2020-04-28 | Flower Orthopedics Corporation | Plating depth gauge and countersink instrument |
US10918426B2 (en) | 2017-07-04 | 2021-02-16 | Conventus Orthopaedics, Inc. | Apparatus and methods for treatment of a bone |
CA3090169A1 (fr) * | 2020-08-17 | 2022-02-17 | Farzad Sadlouparizi | Outil chirurgical et methode d'utilisation pour une procedure de liberation du nerf median au niveau du canal carpien |
Family Cites Families (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2668537A (en) * | 1952-05-16 | 1954-02-09 | Karl A Kapp | Surgical instrument |
ES280274Y (es) * | 1984-06-28 | 1985-12-16 | Perez Alfranca Jose M. | Nuevo aparato para papilotomia transcoledociana en cirugia |
US5089000A (en) * | 1987-09-18 | 1992-02-18 | John M. Agee | Surgical method and instrument therefor |
US4963147A (en) * | 1987-09-18 | 1990-10-16 | John M. Agee | Surgical instrument |
US5053044A (en) * | 1988-01-11 | 1991-10-01 | Devices For Vascular Intervention, Inc. | Catheter and method for making intravascular incisions |
WO1989009029A1 (fr) * | 1989-02-16 | 1989-10-05 | Taheri Syde A | Procede et appareil d'elimination de valvules veineuses |
DE3830704A1 (de) * | 1988-09-09 | 1990-03-22 | Falah Redha | Medizinisches instrument |
DE3918720A1 (de) * | 1989-06-08 | 1990-12-20 | Wolf Gmbh Richard | Retrograd schneidende hakenstanze |
US5234453A (en) | 1990-05-10 | 1993-08-10 | Symblosis Corporation | Cobalt base alloy end effectors for laparoscopic surgical scissors |
WO1992008415A1 (fr) * | 1990-11-09 | 1992-05-29 | Arthrotek, Inc. | Instrument de coupe chirurgical |
US5152772A (en) * | 1991-07-10 | 1992-10-06 | Sewell Jr Frank | Sphincterotomy catheter and method |
US5403328A (en) * | 1992-04-22 | 1995-04-04 | United States Surgical Corporation | Surgical apparatus and method for suturing body tissue |
-
1995
- 1995-05-08 US US08/436,121 patent/US5586990A/en not_active Expired - Lifetime
-
1996
- 1996-05-07 EP EP96915546A patent/EP0939606B1/fr not_active Expired - Lifetime
- 1996-05-07 DE DE69636839T patent/DE69636839T2/de not_active Expired - Fee Related
- 1996-05-07 CA CA002220493A patent/CA2220493A1/fr not_active Abandoned
- 1996-05-07 WO PCT/US1996/006407 patent/WO1996035381A1/fr active IP Right Grant
- 1996-05-07 AU AU57296/96A patent/AU5729696A/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
WO1996035381A1 (fr) | 1996-11-14 |
DE69636839T2 (de) | 2007-08-30 |
EP0939606A1 (fr) | 1999-09-08 |
DE69636839D1 (de) | 2007-02-22 |
CA2220493A1 (fr) | 1996-11-14 |
US5586990A (en) | 1996-12-24 |
AU5729696A (en) | 1996-11-29 |
EP0939606A4 (fr) | 2001-02-14 |
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